Thoracic aortic strain can affect endograft sizing in young patients

Area of Science:

• Cardiovascular Imaging
• Medical Physics
• Radiology

Background:

• Electrocardiography-gated computed tomography angiography (CTA) is standard for aortic imaging.
• Minimizing motion artifacts requires reconstruction in the diastolic phase.
• Understanding aortic strain dynamics is crucial for accurate diagnosis and intervention planning.

Purpose of the Study:

• To quantify aortic strain in elderly patients without aneurysms.
• To identify specific R-R cycle phases corresponding to minimal and maximal aortic diameters.
• To assess the potential for improving intervention planning and dose-saving protocols through strain quantification.

Main Methods:

• CTA images from 28 elderly patients were analyzed.
• Aortic images were reconstructed across 10 phases of the R-R cycle.
• Cross-sectional areas were measured to calculate diameter, pulsatility, and strain, with reproducibility assessed.

Main Results:

• Significant differences were observed between diastolic and systolic aortic diameters.
• Aortic pulsatility varied across segments, with higher values in the thoracic aorta.
• Aortic strain showed moderate negative correlations with age and plaque area.

Conclusions:

• Aortic strain is reliably quantifiable using electrocardiography-gated CTA.
• Routine use of systolic images is not recommended due to substantial aortic pulsatility.
• Maximal aortic diameter occurs at approximately 30% of the R-R cycle.